Immigrant detainees routinely received substandard health care and were given unsanitary food and water that made them sick, according to a report released Thursday by the advocacy group Project South and the Penn State Law Center for Immigrants’ Rights Clinic.

The two privately-operated facilities are part of a vast network of immigration detention centers meant to hold foreign nationals awaiting deportation proceedings after they are detained by the U.S. Immigration and Customs Enforcement (ICE) agency. In the report, researchers found serious violations of ICE’s own standards for care of detainees in health care access, mental health care access, legal representation, and food options.

ICE uses the Performance-Based National Detention Standards (PBNDS) to set guidelines for detention centers. By PBNDS standards, detained immigrants should have “nutritionally balanced” food, clean water, access to legal representatives, and access to phones.

But the report’s authors found that detention facility officers rarely followed those guidelines. Detention center staff members often gave painkillers to immigrant detainees for medical treatment, regardless of the severity of the symptoms. Detainees who complained of growing inches-long bumps on their legs were given ibuprofen, as were people with broken bones.

“If you need any actual medical assistance, you have to sign up at 5 a.m. that morning, and if you’re late, you have to wait until the next day,” a Honduran immigrant told researchers in an interview. “Major medical needs take ten to fifteen days to address.”

Meals were provided at unpredictable hours, with the daily meal schedule leaving seven or more hours between lunch and dinner, the report found. Foreign objects like hair, plastic, bugs, rocks, a tooth, and mice were recurring objects found in the food. And the meals— which was based on a diet of potatoes, white rice, or bread — posed problems for immigrants with diabetes and others with special needs.

“I found a worm in the ground beef once,” a detained immigrant recalled to researchers about his experiences at Stewart. “On top of all of that, the water smells like feces and the showers are covered in mold.”

“Once, for a whole week, we were fed beans that had maggots growing in them,” a detained immigrant from Honduras said.

“There was a worm in my food one time,” another detained immigrant from Honduras said. “You have to eat as fast as you can. You can’t even talk. It is not enough time.”

Researchers additionally found no mental health doctors on staff, with detainees too scared to complain about mental issues because they didn’t want to be put in segregated units. Researchers alleged people who had serious mental afflictions were “given pills and then are placed in handcuffs and helmets and put in segregation, a practice discouraged by ICE, the DOJ [Department of Justice], and human rights standards.”

The report — an update to another one in 2012 called “Prisoners of Profit” — found little has changed in the way private prison operators have treated immigrants at both facilities. That report called for the shut down of private prison-operated facilities, which are paid for each detention bed filled by immigrant detainees and therefore incentivized to follow through on a “ bed quota,” the mandate set by Congress a decade ago to make congressional funding available to maintain 34,000 detention beds on any one night. As of 2016, ICE was holding more than 40,000 people per night.

Although the PBNDS allows for legal visitations, report researchers often encountered detention guards and officials who imposed arbitrary rules to make access to their clients difficult. In one case, detention officials told a legal intern that only attorneys were allowed to visit their client. After several hours of driving to Stewart during another visit, the legal intern and a pro bono attorney were told they couldn’t visit their client because ICE didn’t know about the request in advance, even though a guard had handed over the request a day before. Only three phones worked at Irwin for detained immigrants, researchers said. Phone calls ranged between $5 and $15 for 15 minutes depending on the country and phone calls into other parts of Georgia cost $.30 a minute.

“Unfortunately what we found through the interviews and through touring the facilities and talking to the attorneys, nothing has changed,” Azadeh Shahshahani, lead researcher of both reports and legal and advocacy director at Project South, told ThinkProgress in a phone interview Wednesday. “Conditions are still what they used to be — which is a living nightmare. Our demands still stay the same that these two places need to be shut down.”

The report comes as President Donald Trump has promised to expand the number of immigration detention facilities across the United States in his quest to deport millions of immigrants. One month after Trump took office, the U.S. Department of Homeland Security Secretary John Kelly issued a sweeping memorandum eliminating a number of priorities to turn more immigration violations into deportable offenses.

What troubles advocates like Shahshahani about Trump’s expansion promises is that conditions have yet to improve in current facilities. Six immigrant detainees have died in ICE custody in the 2017 fiscal year, thanks in part to medical neglect. And she’s afraid more issues could arise after more immigrants are put in detention under the Trump administration.

“[The rules are] very arbitrary and varies from detention center to detention center, even though standards are very clear that we as attorneys should be able to visit detained immigrants in the facilities,” Shahshahani said. “There’s no meaningful opportunity to meet with detained immigrants.”